Vraylar

[ma0613]

is there any information on this medication and breastfeeding? Would it likely behave similarly to other atypical antipsychotics?

[admin]

Ma0613:

We unfortunately do not have any data on this new drug. Cariprazine is a new antipsychotic drug. It has two active metabolites desmethyl cariprazine (DCAR) and didesmethyl cariprazine (DDCAR) which are equipotent to cariprazine with much longer half lives. It requires up to 4-6 weeks to attain steady state. Cariprazine acts as a partial agonist at the dopamine D3 and D2 receptors with high binding affinity. While there are no data on its transmission into human milk, its kinetics suggest that milk levels might be high. Some caution is recommended until we know more about this drug.

Tom Hale Ph.D.

PS: Would you be willing to provide milk samples for a study?

[admin]

Ma0613:

The problem with Abilify is that it is known to suppress PROLACTIN levels in some moms and may reduce your milk production.

I'd stick with Vraylar for the time being. Send your contact information to: [url]https://www.infantrisk.com/help-infantrisk-research[/url]

Enter Vraylar AFTER your name and I'll watch for it.



Tom Hale Ph.D.

[ma0613]

After much thought, I don’t feel comfortable risking an untested medication. I am going to speak to my doctor about switching to a first line medication such as Seroquel. However, I am also on Lamictal 200mg and Zoloft 100mg. Would a low dose Seroquel added to these be likely to cause adverse effects due to the stacking of meds?

[admin]

Ma0613:

No, adding a small dose of Seroquel is unlikely to add much risk in this situation. The other drugs doses are moderately low as well.

Tom Hale Ph.D.

[ASchollWI]

Hoping to find any updates about Vrylar and breastfeeding. Seems like the medication is highly protein bound, and lact med now says "Because cariprazine and its active metabolites are >90% protein bound, it is unlikely that clinically important amounts are excreted into milk." Though it seems because of the sited case reports infant risk does not recommend any breastfeeding?

[kaytlin]

Hello!
We've got a manuscript soon-to-be submitted on this one. It's...borderline, plus there are reports of infant adverse effects. I think what's happening is that the half-life of the active metabolite is so long, babies just can't clear it from their bodies. Especially if you take it during pregnancy--the baby will be born with some of the metabolite in their system, and then milk will just add to it. I don't like it for breastfeeding, but every case is different. If a mom is taking Vraylar while breastfeeding, the baby's medical team should be aware and watching out for adverse effects from the drug.

Dr. Krutsch

[ASchollWI]

Thanks so much for the reply. I am curious if using half mothers own milk and half donor milk (obviously without any medication) would make a significant difference in these risks for someone who took Vraylar during pregnancy. Or because the half life is so long, will there be a concerning amount of metabolite accumulation regardless? Also, is your center accepting colostrum and/or mature milk from mom's on Vraylar for study?

[kaytlin]

Partial feedings is always a good way to limit exposure if you're worried about it. The half-life of the metabolite is 1-3 weeks in adults; I can't really say what this would translate to in infants. I'm hoping we can do some modeling in the future to estimate that. To donate milk for research, you can fill out this form and our nurses will contact you: [url]https://infantrisk.com/help-infantrisk-research[/url]